Technical Field
The present disclosure relates to systems and methods for retrieving a biopsy sample, obtaining cytopathological information about the biopsy sample, obtaining genetic information about biopsy sample, identifying a treatment course, performing the treatment, observing the effects of the treatment course on the target from which the biopsy sample was taken, and maintaining an updating a database correlating each of these types of data.
Description of Related Art
A common device for inspecting the airway of a patient is a bronchoscope. Typically, the bronchoscope is inserted into a patient's airways through the patient's nose or mouth and can extend into the lungs of the patient. A typical bronchoscope includes an elongated flexible tube having an illumination assembly for illuminating the region distal to the bronchoscope's tip, an imaging assembly for providing a video image from the bronchoscope's tip, and a working channel through which instruments (e.g., diagnostic instruments such as biopsy tools or therapeutic instruments such as ablation catheters) can be inserted.
Bronchoscopes, however, are limited in how far they may be advanced through the airways due to their size. Where the bronchoscope is too large to reach a target location deep in the lungs a clinician may utilize certain real-time imaging modalities such as fluoroscopy. Fluoroscopic images, while useful present certain drawbacks for navigation as it is often difficult to distinguish luminal passageways from solid tissue. Moreover, the images generated by the fluoroscope are two-dimensional whereas navigating the airways of a patient requires the ability to maneuver in three dimensions.
To address these issues, systems have been developed that enable the development of three-dimensional models of the airways or other luminal networks, typically from a series of computed tomography (CT) images. One such system has been developed as part of the ILOGIC® ELECTROMAGNETIC NAVIGATION BRONCHOSCOPY® (ENB), system currently sold by Covidien LP. Such systems are generally referred to as electromagnetic navigation or EMN systems. The details of such a system are described in the commonly assigned U.S. Pat. No. 7,233,820, filed on Mar. 29, 2004 by Gilboa and entitled ENDOSCOPE STRUCTURES AND TECHNIQUES FOR NAVIGATING TO A TARGET IN BRANCHED STRUCTURE, the entire contents of which are incorporated herein by reference.
Regardless of whether using a bronchoscope or an EMN system, upon identification of a tumor, mass, or other area of interest a clinician will generally take a biopsy in order to conduct pathology testing. The result of the pathology will identify whether the tumor or area of interest is cancerous, and will drive the next steps that a clinician will undertake with respect to that patient. The present disclosure is directed to systems and methods to assist the clinician in determining those next steps.